Diabetes mellitus is a metabolic disorder that occurs when the body either doesn’t produce sufficient insulin or doesn’t use insulin properly causing blood sugar (glucose) levels to rise (hyperglycemia).
There are 3 main types:
- Type 1 diabetes (formerly called juvenile or insulin-dependent diabetes) is a condition in which little to no insulin is produced by the pancreas.
- Type 2 diabetes occurs when the body doesn’t use insulin properly, causing blood sugar levels to rise. It is the most common form of diabetes.
- Gestational diabetes is a condition that disrupts the way the body uses sugar (glucose) during pregnancy. Pregnancy increases the body's need for insulin, but the body is not always able to make enough.
There is no way to cure type 1 diabetes, no matter what foods you eat. It is an autoimmune condition, which means it is chronic and will need to be managed for the rest of your life.
After delivery, gestational diabetes usually goes away and a woman’s blood sugar levels will return to normal and no special diet is needed, however, women with gestational diabetes have an increased risk of developing type 2 diabetes later in life, and up to two-thirds of women who have gestational diabetes in one pregnancy will have it again in a subsequent pregnancy so maintaining a healthy diet is important.
Type 2 diabetes may be able to be cured with diet, exercise, maintaining a healthy weight, and lifestyle changes; however, healthy eating habits need to be maintained for life.
There is no specific diet to “cure” diabetes. Patients should follow a diabetes meal plan as recommended by a doctor or nutritionist. Foods to eat and foods to avoid include:
- Carbohydrates from fruits, vegetables, whole grains, legumes, and low-fat milk
- A variety of eating patterns are acceptable, such as:
- Low fat
- Low carbohydrate
- Mediterranean
- Vegetarian
- Vegan
- Talk to your doctor before starting an extremely restrictive diet, such as a very low carb or “keto” diet
- Monounsaturated and polyunsaturated fatty acids such as those found in fish, olive oil, and nuts are recommended
- Saturated fats such as that found in in meats, cheese, and ice cream, as well as trans fats, should be kept as low as possible
- A diet high in fiber can help keep blood sugar levels under control
- Good protein sources include lean meats, fish, eggs, beans, soy, and nuts
- Limit red meat
- Drink plenty of water
- Avoid sugar-sweetened beverages, including soda and fruit juice
- Limit or avoid sodium to keep blood pressure under control
- Limit sugar intake
- “Sugar-free” or “fat-free” products are not necessarily low in calories or carbohydrates
- Read all nutrition labels carefully
- Some sugar-free foods, such as sugar-free gelatin and sugar-free gum, do not have a significant number of calories or carbohydrates and are considered “free foods”
- Any food with fewer than 20 calories and 5 grams of carbohydrate is considered a “free” food, meaning it does not affect body weight or require an adjustment to medication
What Are Symptoms of Diabetes?
Symptoms of diabetes include:
- Increased urination
- Increased thirst
- Increased hunger, even though people are eating
- Blurred vision
- Fatigue
- Sores/cuts/bruises that do not heal
- Frequent infections
- Darkened skin, often in the armpits and neck
- Numbness, tingling, or pain in the feet or hands (more common in type 2)
- Unexplained weight loss (more common in type 1)
What Causes Diabetes?
Type 1 diabetes is believed to be caused by an autoimmune reaction in which the body attacks itself and destroys the beta cells in the pancreas that make insulin.
Risk factors for developing type 1 diabetes include:
- Genetics
- Certain triggers, such viruses
Type 1 diabetes is not caused by diet or lifestyle factors.
Type 2 diabetes is caused by several factors, including:
- Genetics
- Family history
- Tends to occur more in certain ethnic groups: African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, Native Hawaiian, or Pacific Islander
- Lifestyle factors
- Being overweight or obese
- Physical inactivity
Factors that may increase the risk of developing type 2 diabetes include:
- Age 45 or older
- Low HDL (“good”) cholesterol or high triglycerides
- High blood pressure
- A history of heart disease or stroke
- A history of gestational diabetes
- Giving birth to a baby weighing 9 pounds or more
- Depression
- Polycystic ovary syndrome (PCOS)
The cause of gestational diabetes is not known and it is difficult to predict which women could develop the condition when they are pregnant.
Risk factors for developing gestational diabetes include:
- Prior gestational diabetes during pregnancy
- Family history of diabetes
- Being overweight/obese
- Age older than 25
- Ethnicity: Hispanic-American, African-American, Native American, South or East Asian, or Pacific Islander
How Is Diabetes Diagnosed?
Diabetes is diagnosed with the following tests:
- Fasting plasma glucose (FPG) test
- A1C test
- Glucose challenge test
- Random plasma glucose (RPG) test
- Oral glucose tolerance test (OGTT)
What Is the Treatment for Diabetes?
Diabetes is treated with lifestyle modifications and medications when needed.
Lifestyle changes to manage diabetes include:
- Manage A1C (average blood glucose level over the past 3 months)
- Check blood glucose levels daily
- Keep blood pressure in check
- Maintain healthy cholesterol levels
- Don’t smoke
- Follow a diabetes meal plan as recommended by your doctor or nutritionist
- Exercise regularly
- Get adequate sleep
- Manage stress/practice relaxation techniques
- Take prescribed diabetes medications
Medications used to treat diabetes include:
- Insulin
- Meglitinides
- Alpha-glucosidase inhibitors
- Thiazolidinediones
- DPP- 4 Inhibitors
- Sulfonylureas
- Biguanides
- Dopamine receptor agonists
- Bile acid sequestrants
- SGLT2 inhibitors
- GLP-1 receptor agonists
- Amylin analog
- Combination medicines, which may be made up of more than one medication in the above classes
If lifestyle changes and medications are insufficient, other treatments for diabetes may include:
- Weight-loss surgery (bariatric surgery) for certain patients who are obese
- Artificial pancreas
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https://www.fda.gov/media/119148/download
https://www.cdc.gov/diabetes/basics/type1.html
https://www.uptodate.com/contents/gestational-diabetes-beyond-the-basics?search=Gestational%20Diabetes%5C&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2
https://www.uptodate.com/contents/type-2-diabetes-and-diet-beyond-the-basics?search=diabetes&topicRef=15730&source=see_link